Improved Alertness Is Associated with Early Increase in Serum Brain-Derived Neurotrophic Factor and Antidepressant Treatment Outcome in Major Depression

Abstract

Background/Aims: In major depression cognitive impairment is common and may persist despite improvement in psychopathology. So far it is unclear how closely related improvement in cognitive functioning is to the clinical course of depression. Further, it is unclear whether recovery from cognitive impairment is linked to changes in serum brain-derived neurotrophic factor (sBDNF). The objectives of this study were (1) to explore the predictive value of cognitive impairment for therapeutic outcome, and (2) to assess the association between cognitive performance and sBDNF levels over a 6-week course of antidepressant treatment. Methods: Twenty-five adult patients suffering from major depression underwent standardized treatment with duloxetine. Both severity of depression as assessed by the Hamilton Depression Rating Scale and sBDNF levels were measured at baseline, and after 1, 2 and 6 weeks of treatment. Cognitive performance, i.e. alertness, working memory, and divided attention, was assessed at baseline, after 1 week, and at the end of treatment after 6 weeks. Results: Higher performance in alertness and divided attention at baseline correlated with less severe depression at week 6. During the first week of treatment, a greater increase in sBDNF was associated with a greater improvement in alertness at week 6. Conclusion: Greater alertness at baseline was a predictor of favorable antidepressive treatment outcome. Moreover, the early increase in sBDNF correlated with improvement in attention functioning. Thus, recovery from cognitive impairment and an early increase in sBDNF seem to be associated.

A Systematic Review of Cognitive Predictors of Treatment Outcome in Major Depression

“…Whilst one small study has found an association between poorer executive function/attention performance and poor response to SNRIs ( n = 25) (21), a much larger study has found no evidence of a relationship ( n = 204) (20). …”

Meta-analyses of comparative efficacy of antidepressant medications on peripheral BDNF concentration in patients with depression

“…After screening titles and abstracts, 56 full-text articles were reviewed, of which 36 were excluded for the following reasons: (i) two studies were duplicated cohorts; (ii) five studies were reviews or meta-analyses; (iii) seven studies did not assess BDNF pre- and post- antidepressant treatment; (iv) six studies compared the BDNF val66met SNP; (v) twelve studies did not compare antidepressant medication but analyzed effects of other methods(ECT, sleep deprivation therapy, exercise et al) on BDNF; (vi) data from two studies could not be obtained; (vii) two studies did not measure BDNF, either in plasma or serum. Hence, twenty studies were ultimately included in this meta-analysis based on our inclusion criteria [ 19 , 21 – 39 ]. The study characteristics are displayed in Table 1 .…”

Impact of a Dietary Supplement Containing Rosemary and Daylily on Biochemical Markers of Cognitive Health, Sleep Quality and Related Variables in Men and Women

“…Brain-derived neurotrophic factor, a member of neurotrophin family, exists in the brain, as well as in other tissue such as skeletal muscle. It plays a central role in mood disorders [26] and is associated with improved cognitive performance [27] and alertness [28]. The significant increase in BDNF with treatment of the supplement may provide mechanistic evidence for the improvement in our subjective measures of mood, such as alertness, focus, and enthusiasm.…”